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Métodos Terapéuticos y Terapias MTCI
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NCI Monogr ; (1): 129-34, 1986.
Artículo en Inglés | MEDLINE | ID: mdl-3534585


Between 1974 and 1977, a total of 254 patients with stages T1-3a, N0-1, and M0 operable breast cancer (node negative and node positive, stratified) were randomized to either modified radical mastectomy alone or the same surgery and adjuvant chlorambucil, methotrexate, 5-fluorouracil (LMF) plus BCG. After a median follow-up of 9 years (January 1985), we concluded that LMF plus BCG significantly increased relapse-free survival (RFS) in 240 fully evaluated patients, especially postmenopausal women. This gain in RFS ceased to transform into a gain in overall survival (OAS) after 7 years of median follow-up for the whole patient group. In the 122 node-negative patients studied, LMF plus BCG produced a marked increase in RFS up to the fifth year and in OAS up to 8 years after initial surgery, thus prolonging significantly the median disease-free interval compared with surgical control patients. This trend favoring LMF plus BCG-treated patients continues. Although median time to first relapse and to generalized disease were increased in relapsing patients by LMF plus BCG, the subsequent intervals from local relapse to distant disease and from distant metastases to death were equal for both treatment regimens. Subjective and objective acute toxicity from LMF plus BCG was mild. At 9 years of median follow-up, fewer second tumors were noted in the node-negative group receiving LMF plus BCG than in surgical controls.

Vacuna BCG/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Clorambucilo/administración & dosificación , Fluorouracilo/administración & dosificación , Metotrexato/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/toxicidad , Neoplasias de la Mama/cirugía , Ensayos Clínicos como Asunto , Femenino , Estudios de Seguimiento , Humanos , Metástasis Linfática , Mastectomía , Persona de Mediana Edad , Suiza
Infection ; 10 Suppl 3: S131-7, 1982.
Artículo en Alemán | MEDLINE | ID: mdl-6218100


Fifty-six patients suffering from severe and very severe bacterial infections received additional antibacterial treatment with mezlocillin following abdominal or chest surgery. There were 18 intestinal-peritoneal infections, 15 pleuropulmonary infections, seven patients with sepsis, six localized abscesses and ten patients receiving perioperative application. In 36 patients treatment had to be initiated before the pathogens had been identified. Twenty patients received mezlocillin alone and 37 in combination with an aminoglycoside. The clinical course and laboratory data were recorded while the patients were receiving antibiotic therapy. In 43 of the 56 patients, most of whom were suffering from mixed infections caused by anaerobes and aerobes or from fecal infections, a cure without complications could be achieved. In six patients a generalized infection was reduced to a local one which could be cured. Eight patients died, six of their surgical primary disease and two of septic complications. Apart from four instances of phlebitis at the site of the infusion, no side-effects resulted from our antibiotic therapy.

Abdomen/cirugía , Infecciones Bacterianas/tratamiento farmacológico , Penicilinas/uso terapéutico , Infección de la Herida Quirúrgica/tratamiento farmacológico , Cirugía Torácica , Adulto , Anciano , Empiema/tratamiento farmacológico , Ácidos Grasos/sangre , Femenino , Humanos , Enfermedades Intestinales/cirugía , Masculino , Mezlocilina , Persona de Mediana Edad , Complicaciones Posoperatorias/tratamiento farmacológico , Tobramicina/uso terapéutico
Recent Results Cancer Res ; 80: 177-84, 1982.
Artículo en Inglés | MEDLINE | ID: mdl-7036281


A randomized surgical adjuvant trial in 242 evaluable patients with T1-3a, N0-1, and M0 breast cancer was initiated 4 years ago. The well-tolerated, oral combination chemotherapy with six cycles of Leukeran plus methotrexate plus fluorouracil (LMF) plus repeated BCG skin scarifications was used. After 4 years, the following results were seen: (1) significant increase of relapse-free (RFS) and also overall survival (S) in both pre- and postmenopausal node-negative patients versus surgical controls (RFS 91.1 vs. 701%, P = 0.003; S 96 vs. 88%, P = 0.03); (2) no significant increase of RFS or S in pre- and postmenopausal node-positive patients versus surgical controls (RFS 50.1 versus 44%, P = 0.49; S 70 versus 68 %, P = 0.9, respectively); (3) Patients receiving greater than 90% of the planned LMF dose showed significantly better survival after 4 years; and (4) Nonrandomized comparison with concurrent Swiss adjuvant studies with LMF alone indicate no beneficial or harmful effect of BCG skin scarifications in addition to the six-cycle LMF.

Neoplasias de la Mama/terapia , Clorambucilo/uso terapéutico , Fluorouracilo/uso terapéutico , Metotrexato/uso terapéutico , Neoplasias de la Mama/cirugía , Ensayos Clínicos como Asunto , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Inmunoterapia , Metástasis Linfática , Menopausia , Mycobacterium bovis/inmunología
Helv Chir Acta ; 47(5): 541-5, 1980 Dec.
Artículo en Alemán | MEDLINE | ID: mdl-7204075


The rate of recurrent duodenal ulcer following selective proximal vagotomy (SPV) has been assessed in two different groups of patients. Completion of vagotomy was left to the surgeons judgement in the first 50 consecutive cases, while in the following 50 cases a vagomotor electrostimulation device ("Vagorec") was used intraoperatively for control. The failure rate of 14% in the first group could be reduced to 2% in the second one. We believe that technique and success of SPV can be checked easily using this device. It is an educational remedy for the learning surgeon in order to avoid an incomplete SPV as well as it is a necessary tool for the experienced one.

Vagotomía Gástrica Proximal , Vagotomía , Úlcera Duodenal/prevención & control , Estimulación Eléctrica , Gastroscopía , Humanos , Vagotomía/métodos , Vagotomía Gástrica Proximal/métodos